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Pol. Merkur. Lek (Pol. Med. J.), 2011, XXXI/181: 048-051 Maximize

Pol. Merkur. Lek (Pol. Med. J.), 2011, XXXI/181: 048-051

Title: Impact of L-thyroxine replacement therapy on pituitary changes secondary to congenital primary hypothyroidism – three cases report

Authors: Łącka K., Gradecka-Kubik I., Czyzyk A., Rajewska J., Paprzycki W.

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SUMMARY IN POLISH & ENGLISH. FULL ARTICLE ONLY IN POLISH.

Impact of L-thyroxine replacement therapy on pituitary changes secondary to congenital primary hypothyroidism – three cases report


Łącka K.1, Gradecka-Kubik I.2, Czyzyk A.3, Rajewska J.4, Paprzycki W.5

1University of Medical Sciences in Poznań, Poland, Department of Endocrinology, Metabolism and Internal Medicine; 2University of Poznań, Poland, Outpatients Unit of Internal Medicine; University of Medical Sciences in Poznań, Poland: 3Department of Gynecological Endocrinology; 4Student’s Scientific Society; 5Magnetic Resonance Center, Department of Radiology

The aim of the study was an evaluation of the impact of L-thyroxine substitution therapy on the size and structure of the pituitary gland using MRI in three patients with pituitary hyperplasia or tumor secondary to primary congenital hypothyroidism. Along with imaging studies (MRI, skull X-rays) all patients had performed hormonal tests. All hormones (except adrenocorticotropic hormone) of anterior pituitary lobe were measured in basal condition, and some of them (GH, PRL) after stimulation tests, which showed hyperprolactinemia in one case and pituitary somatotropin insufficiency in the other. Only in one out of three patients the regression of the pituitary enlargement was complete, whereas in second case the regression was partial and in third patient evaluation revealed no changes on the MRI.
Correct L-thyroxine therapy prevents enlargement of pituitary gland and may regress these changes, but is not the only outcome of pituitary enlargement. Those results shows, that other coexisting disturbances like TSH-secreting adenoma or thyroid hormone resistance must be considered when the treatment is not successful.

Key words: congenital hypothyroidism, pituitary MRI, L-thyroxine therapy

Pol. Merk. Lek., 2011, XXXI, 181, 48